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A lipoma is one of the commonest types of benign tumor and a neurolipoma is one of its rarer variants. It is also called as Neurofibrolipoma (NFL) or lipomatosis of nerve. It can occur in a person with neurofibromatosis. The most common sites of occurrence are the volar aspects of the hands, wrists, and forearms. These NFLs are observed in young people, usually men. The median nerve is most commonly involved. Lower-extremity cases are extremely rare. We report here a rare case involving the lower limb without any skeletal deformities occurring in a young man.

Alipoma is one of the commonest types of benign tumor and a neurolipoma is one of its rarer variants. It is also called as Neurofibrolipoma (NFL) or lipomatosis of nerve. It can occur in a person with neurofibromatosis. The most common sites of occurrence are the volar aspects of the hands, wrists, and forearms. These NFLs are observed in young people, usually men. The median nerve is most commonly involved. Lower-extremity cases are extremely rare. We report here a rare case involving the lower limb without any skeletal deformities occurring in a young man. [ABSTRACT FROM AUTHOR]

Soft tissue masses of the fingers have a broad differential, including both benign and malignant etiologies. Of these, lipomatous tumours of the finger are exceedingly rare, with the subset of neurolipomas, rarer still. Often referred to as lipofibromatous hamartoma (LFH), or lipomatosis of nerve, among more than ten other descriptive terms, these tumours are generally associated with macrodactyly and frequently involve branches of the median nerve of the upper extremity, leading to a spectrum of neurologic sequelae. These tumours represent a diagnostic challenge due to their rarity and neural involvement, which may complicate standard biopsy techniques. Optimal surgical management is dependent on the final diagnosis, if known, or clinical judgement when a biopsy is not feasible. We present a case of a 17-year-old male with an index finger lipomatous soft tissue mass with lesional enhancement seen on imaging. The decision was made to perform an excisional biopsy, with intralesional dissection and preservation of the involved digital nerve. Based on the pathologic findings, he was diagnosed with neurolipoma of the finger without associated macrodactyly. Given the benign nature of these lesions, marginal excision without sacrifice of the involved nerve is recommended. Still, a high index of suspicion should always be employed if an underlying malignancy is suspected in which case wide excision, or amputation would be the treatment of choice after the diagnosis is confirmed. The diagnostic, intraoperative, and postoperative findings of the case are discussed.

Background: Lipoma is a nonneurogenic benign tumor. Neurolipoma and fibrolipomatous hamartoma are variants of this universal tumor. All these variants are grouped under lipomatosis of the nerve. Majority of these tumors are asymptomatic, which can be observed. Symptomatic patients require surgery, which is not standardized. As there are insufficient number of cases, no randomized controlled studies have been performed in the treatment of fibrolipomatous hamartoma. The aim of our study was to determine the pattern of presentation of fibrolipomatous hamartoma, surgical management offered, and the outcome in the form of recovery and complications. Materials and Methods: This retrospective descriptive study includes six patients diagnosed with fibrolipomatous hamartoma over a period of 12 years. Patient details were collected from the medical records. Patients diagnosed of fibrolipomatous hamartoma in the hand were included. Patients with other soft-tissue tumors were excluded from the study. Out of six patients, four required excision of nerve followed by reconstruction using sural nerve graft and two underwent microsurgical dissection of neural element. Patients were instructed to take care of the operated hand during the recovery phase. Institutional physiotherapy protocol was started during the 3rd postoperative week. Follow-up period was between 1 and 3 years. Results: All the six patients were free from symptoms postoperatively. Minimal complications were noted in two patients, which were managed conservatively. Conclusion: Surgical excision of fibrolipomatous hamartoma of median nerve below elbow, with nerve dissection or with nerve reconstruction using sural nerve graft, followed by proper postoperative care and physiotherapy has proven beneficial for the patients in our study.

A lipoma is a common type of benign tumor and a neurolipoma is one of its variants. It is also referred to as neural fibrolipoma, fibrolipomatous hamartoma, intramural lipoma, and lipomatosis of nerve. The most common sites of presentation are the volar aspects of the hands, wrists, and forearms of young persons. The median nerve is most commonly involved. Lower-extremity cases are extremely rare. We report here a rare case involving the median nerve without any skeletal deformity occurring in a male patient. It usually presents with swelling associated with pain and tenderness.